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The "Make Nurses Doctors" Movement

RUSH: Basin, Wyoming, next. Josh, great to have you on the Rush Limbaugh program. Thank you for waiting, sir. Hello.

CALLER: Thank you, Rush. The reason I called is because earlier in your show you said that lateral movement is one of the biggest problems in our country right now, and I wanted to add to that and say that I think health care is actually one of the worst fields for allowing people to move laterally. When you have a nurse working in a long-term care facility for 30 years performing treatments, passing out medications, those people are capable of moving into the role of a geriatric doctor and competing against those people and driving down costs. But unless those people want to pay another hundred thousand, $200,000 into the Guild so they can say that they do have that knowledge and that experience, they can't move into that role and compete against, you know, their peers.

RUSH: Wait. I don't think... I haven't used the word "lateral" on the program today. Are you listening to this program today?

CALLER: Oh, yeah. Well, I thought earlier you were talking about people being able to move up in their career paths.

RUSH: Right.

CALLER: Like as in lateral movement, right?

RUSH: Well, no movement. Some people can't move.

CALLER: Yeah, that's what I'm saying.

RUSH: Some people are either losing jobs or they're losing ground, but the amount of upward mobility in the middle class is what I was talking about. What I said was that in any economy, good or bad, when things didn't go great, somebody gets hurt. When things are going poor, somebody's doing well, and there are always going to be a few entrepreneurs that are always gonna triumph no matter what just because some people are inclined that way.

But the great thing about America and capitalism, was that the middle class in this country always had upward mobility. They always had the ability. If they did want to work hard, if they want to educate themselves, if they wanted to use all their ambition, they could increase their standard of living. That was almost a guarantee in America. That's gone now, because the pie is shrinking. The private sector's getting smaller as the government's usurping it.

CALLER: I totally agree.

RUSH: You heard me say that. Now, you're talking about a specific where some nurses are not allowed to become doctors, I think, right?

CALLER: Well, not just specifically that. I mean, CNAs should be able to move into the role of nursing. Nurses should be able to move up into the role of doctors, as they gain more experience and more knowledge, because that's just stagnating people into --

RUSH: No, no, no. Wait a minute.

CALLER: -- jobs as dumb as their degree says they are.

RUSH: Wait a second. Why should a nurse, with only job experience, be able to become a doctor?

CALLER: In long-term care facilities, you usually have like 80 or 90 patients in a building, and you have the nurses 40 hours a week doing all the treatment, doing all the medication, and maybe once a month you actually have the doctor come in and visit a handful of these 80- or 90-patient buildings, and they're making more money than the nurses who are doing all of the work and all of the labor, and they don't get any credit for gaining more knowledge and more experience. They don't get to make more money as they gain more knowledge and experience unless they want to go back to school and pay for it.

RUSH: There you go. You don't become a doctor by becoming a nurse first. It's never happened, unless the nurse quits and goes to medical school.

CALLER: Yeah.

RUSH: And spends seven or eight years there.

CALLER: Yeah. I mean, I know nurses that have been in health care for 30 years that, in my opinion, are even more competent than some of the newer doctors being released out into this field, and yet they're making more money because that nurse can't claim that she has more knowledge. She can't claim that they aren't competent or capable.

RUSH: It's not just that. She's not accredited. She hasn't been educated to be a doctor. She hasn't gone to school. She hasn't passed the Hippocratic oath test or whatever the heck it is. I know what we're getting at here is, it isn't fair, and what we're getting at are these doctors. Look, isn't this typical? "These guys are making all the money and they don't do any work. They're out there playing golf.

"They're making so much money, they don't even know how to count it all. They can't keep their finances straight. These guys show up once, they do their rounds, they don't even care if the patient dies. Whenever the patient codes, is it the doctor? No, it's the nurse. To hell with the doctor!" I get it. I really do, and it just isn't fair. I know nurses are mostly women, and it just isn't fair, 'cause after being 30 years as a nurse you probably know more than most doctors anyway 'cause you've been doing all the work.

The doctors, they're not really doctors.

They didn't really do that.

The nurses do it all.

I know. (interruption) That's exactly right. It is inequality. It is unfairness. It is discrimination. It is bias, it's prejudice. I'm sure there's nobody who can fix it. (interruption) No, Obama can't fix this. Only the nurses can fix it. (interruption) No. There's no executive order that will qualify. (interruption) Well, no. There's no executive order that would make a nurse a doctor after, you know, so many bedpan changes or whatever the qualifications are.

It's not gonna happen.

BREAK TRANSCRIPT

RUSH: I guess I need to apologize, because I caught hell when that call from Josh ended. I'm convinced, by the way, that Josh is an SEIU union rep. Because just in the short break there, I did a little looking up, 'cause I caught hell. My own staff said, "You didn't understand what he was saying! He wasn't saying (unintelligible griping)! It's still not fair!" I was descended upon here by my own staff.

"He's right! He's right. At these long-care facilities the doctors only show up one or two times and the nurses do all the work! You don't know what you're talking about!" My own staff was saying this to me. So I'm sitting here thinking there is something happening out there, not often, but this has really happened. This zoomed right by me. I did not know. I just looked it up and I found out that it does exist, and I'm begging your forgiveness. I did not know that there was a movement on to qualify nurses as doctors.

The SEIU is pushing for this, for nurses to become doctors, precisely on the basis of Josh's call: It isn't fair. The nurses are doing all of the work and the doctors are not showing up much. One of the arguments is, "Look, even if you don't make 'em doctors, at least pay 'em a little more! They're doing all the work. It isn't fair, it isn't fair!" There's apparently a massive movement going on.

Well, I don't know about "massive," but it is being spearheaded by the SEIU.

There are also nurses. By the way, I have no dog in this fight, folks. Do not infer a tone in my voice here. There are nurses who want to consider their educations to be the equivalent of doctorates, and they want to be called doctors. Dr. Nurse Jones, Dr. Nurse Hilda, or what have you. So that is something that's happening out there. But it is clear that there is a pretty high degree of resentment for doctors who are not doing very much and farming a lot of the day-to-day care off on the nurses.

The nurses are saying, "We need to be paid more. We're the ones doing all the work, and they're getting all the money," and this is a union-led movement from what I've been able to find, again, just in a short period of research during the break. I mean, even as we speak, ladies and gentlemen, the one hospital in New York City that is not completely unionized is voting on signing up with the Service Employees International Union.

That hospital is Elmhurst Hospital in Queens. This is one reason why the SEIU has backed Obamacare so strongly. They've been trying to sign up as many members as they can by unionizing hospitals. Now, that may be a separate movement from what everybody is thinking is a fairness and an inequality issue. So that's as much as I've been able to learn about this in the break.

As H.R. pointed out to me, this same kind of contretemps has occurred in the legal community with paralegals. After a while, they start thinking they're the real thing, and the lawyers start farming more and more out to 'em, but they're just para's, and they're thinking it's a screwball arrangement. "We're called 'para' so you don't have to pay us anything." It's sort of like miniature interns. "We're not para-anything. We end up doing all the work, and these guys are at the club or whatever it is they're doing.

"We're the ones turning in the billable hours, and they're not doing anything." Yeah, that's called "partnership," and the thing is they used to do that when they were young. They might not have been paralegals. One of the problems here, I think, is human nature. This has been around a long time. You know, most people, history is their life. There is no other history. Nothing has ever happened of any consequence if it didn't happen when they were alive.

So there are a lot of people who look at those at the pinnacle of their success and think they've always been there, and have a deep resentment for it, and do not realize that those the people at one time in their lives were schlubs and they were on the low rungs of the ladder, and they were working hard and putting in all the hours, and they were climbing, and they did what it took to get where they are.

But if you never saw somebody engage in what it took to get there, it might be easily assumable that they didn't do that work. They just lucked out, and you hear the president say, "You didn't build that! You didn't get there on your own. You couldn'ta done it without somebody else," and you easily create an alternative reality where the successful are chosen.

And if you're not chosen, you're not gonna be successful; you're just gonna be used and exploited. The thing is, everybody that becomes a nurse, I would think, knows what the job is. Everybody who becomes a teacher knows what the job is. This is where I'm the mayor of Realville. I admit, this is where it would be easy for you some of you to say, "Rush, you're out of touch," but I'm not. I am so in touch, you can't believe it. But just to illustrate my point. When I was young I was making $12,000 year living in Kansas City in a shack. But I saw the neighborhoods where successful people lived, and I would drive through 'em and say, "What do these people do?"

And I'll tell you one thing I knew they didn't do. I knew there weren't any nurses in there, and I knew there weren't any teachers. I knew what they made. I said, "Well, who are they?" Okay, you figure some doctors and lawyers, but what else is in there? If earning a lot of money is what you want, who are they and how did they do it? Sometimes I felt like knocking on the door and just asking. I never did it, but I was curious about it, 'cause, remember, I wasn't going to school. I wasn't following any proscription. I wasn't following any approved route: go to college, get an education, be a schlub for a while, be a junior partner. I wasn't doing any of that. So I was just curious. And I had no role models, in that sense. I mean, I did, but not in a direct sense.

I was following the route for radio. No question I paid my dues. I did. But at the time I was going through the neighborhoods I was out of radio, I had quit. I was working for the baseball team. I was in corporate America. How do you do it here? I figured out, whatever it takes here, I don't want to do it. So after five years I left. Nothing wrong with it. It wasn't for me. But my point is, when you go to nursing school, you know you're the one that's gonna be seeing the patient much more often than the doctor is. Because you've been a patient and you know you've seen the nurse much more often than you've seen the doctor. The doctor, once a day, maybe. And if you're really not sick, maybe once a week. So you know.

If you join a union, you know what you're getting into. You should. You know you're sacrificing your individuality and you're gonna be paid exactly what everybody else in the group's getting paid, and that's gonna be according to whatever the contract is negotiated to be. And it isn't gonna have anything to do with how well or how poorly you do your job, 'cause you're not paid on that basis. You're paid on the basis of what your negotiator can score from the company, terms of the contract, and your only option to earn more is overtime or quit and do something else.

So that's why I have a little bit -- not a problem. Didn't say problem. It's not a lack of sympathy. It's just, well, wait a minute, you knew when you chose this profession what it was. And so now 10 years later, all of a sudden you're being exploited and used, and it's unfair. I remember, folks, this is human nature. My first two years working at the little radio station in my hometown, every one of us thought the owner was the biggest blithering idiot on the face of the planet. We'd all get together and talk about what a dummkopf he was and how we would be running it better if we were in charge and how we'd be doing this different and we'd be doing that better and we wouldn't be as cheap.

And one day I got home late, and my dad said, "What have you been doing, son?"

I said, "Well, I was with some of the guys at the station."

"What were you doing?"

"Ah, you know, we're complaining about the owner," and he just lit into me. "You were what?"

And I said, "Yeah, we're talking about what an idiot the guy is and how he ought to be doing this and that," and my dad lit into me.

"You don't have the slightest idea what you're talking about. You don't know who that man is. You don't know what he's done to get there. Who in the hell are you to say? You're two years doing this and you think you've got all the answers?"

He just lit into me like you can't believe, said he'd be embarrassed. And I said, "Well, how many times have I heard you say that the judge didn't know what he was talking about?"